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School's Out! Volunteer Day Program Registration & Waiver

1. Contact Information *This question is required.
2. What are the teen's preferred pronouns? (Check any that apply)
This question requires a valid date format of MM/DD/YYYY.
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4. Teen Grade Level *This question is required.
5. Does your teen have allergies or food avoidances? *This question is required.
What are they allergic to or need to avoid?
If they have anaphylaxis we request that you provide our staff with an allergy action plan from your doctor. You can chose to have staff carry the epi-pens or your teen self-carry.
6. How did you learn about this volunteer opportunity?
7. Does your teen have an hour requirement through school or a club that this opportunity is helping to fulfil?

I certify that I am a parent or legal guardian of the minor child applying to volunteer with the City of Fort Collins (“City) and that all statements made in this application are true and complete.  I authorize the City to investigate all statements made as a part of this application and to secure any necessary information about the minor child noted from all prior employers, volunteer programs, references, academic institutions, law enforcement agencies, other persons and entities, and public records. On behalf of the minor child, I hereby release all such persons, entities, employers, volunteer programs, references, institutions, agencies and the City from any and all liability arising from their giving or receiving information about the  employment history, academic credentials, qualifications, reputation, driving record, and criminal record of the minor child noted.  A photocopy of this release can be used for all purposes.  

The minor child and I understand that successful completion of a background check is a qualification for certain volunteer positions with the City.  Once an active volunteer, the minor child and I understand that if the minor child is charged with any felony offense, whether the offense allegedly occurred on duty or off duty, I must report the charges to the minor child’s City supervisor immediately following notice of charges. 

The minor child and I understand that any false answers or misleading statements as well as misrepresentations by omission made by me on behalf of the minor child as part of the minor child’s application, will be sufficient for rejection of the minor child’s application or for the minor child’s immediate discharge should one be discovered after the minor child has started volunteer activities. 

The minor child and I understand that nothing in this volunteer application, in the City's statement of personnel policies, or in communication with any City employee or official is intended to create an employment contract between the City and the minor child. Accordingly, either the City or I or the minor child may terminate the minor child’s volunteer status at-will at any time with or without cause or notice. The minor child and I understand that the at-will nature of the volunteer relationship can only be changed in a specific writing signed by the Director of Human Resources. The minor child and I understand that the minor child will not be paid or receive any other remuneration for the minor child’s services as a volunteer with the City.  

The minor child and I understand that the City will provide excess accident medical insurance in the event that the minor child is injured while acting as a City volunteer. This insurance coverage has a limit of $10,000 and has other limitations and exclusions that I should become familiar with. The minor child or I may obtain additional information concerning the accident insurance policy from the City's Risk Management Department. The minor child and I understand that the City will not provide any other coverage for injury to the minor child and the minor child will not receive Workers’ Compensation coverage.  

I hereby represent that the minor child is under the age of eighteen (18) years and that the minor child wishes to provide volunteer services to the City of Fort Collins.  I understand that, depending on the minor child’s assignments as a volunteer, the minor child may be exposed to risks and hazards that could result in property damage, bodily injury, or death, including but not limited to: outdoor activities on wet, rough or rocky terrain; approaching, ascending, descending and traversing hiking trails; exposure to weather, plants, animals and other outdoor hazards; physical exertion; transportation in a City vehicle; exposure to COVID-19 and working with and around tools and dangerous equipment. I am aware of the risks and hazards inherent in my participation as a volunteer and, recognizing those risks and hazards, on behalf of the minor child, I hereby request that the minor child provide volunteer services.  

By this Acknowledgement and Release, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk on behalf of the minor child that the minor child may be exposed to or infected by COVID-19 by volunteering for the City and that such exposure or infect may result in personal injury, illness, permanent disability and death.  I voluntarily agree to assume all of the foregoing risks on behalf of the minor child related to exposure to COVID-19, accept sole responsibility for any injury the minor child may sustain (including but not limited to personal injury, disability and death), damage loss, claim, liability or expense, of any kind, that the minor child or I may experience or incur in connection with the minor child’s volunteer service.  In exchange for the minor child’s participation in the City’s volunteer services program, I on behalf of the minor child agree to release the City, and its employees, agents and officials, from any liabilities, claims, legal action, damages, costs or expenses that may arise from such injury, illness, loss, claim, liability or expense.

The minor child will not drive a vehicle to conduct City business unless authorized to do so by his or her City supervisor. I understand that I must report all traffic violation citations issued to the minor child while driving on City business, or any suspension or revocation of his or her driver’s license, to a City supervisor immediately.  Prior to conducting any City business in an automobile, on behalf of the minor child, I will secure and maintain all State of Colorado insurance requirements and the minor child will hold a valid Driver’s License any time he or she conducts City business in an automobile.          

Photo Release

City staff or other volunteers may take photos of volunteer activities for City marketing purposes unless a volunteer provides written notification to the City that he or she does not authorize use of volunteer’s photos for this purpose.

Handbook Acknowledgement 

On behalf of the minor child, I agree the minor child will abide by the procedures outlined in the Volunteer Handbook while volunteering at the City of Fort Collins.

On behalf of the minor child, I further acknowledge and agree that while volunteering for the City of Fort Collins the minor child will not be an agent, servant or employee of the city, will not be entitled to any wages or compensation of any sort, and will not be covered by the city’s employee benefits, including worker’s compensation. Further, nothing in the Volunteer Handbook shall be construed to create an employment relationship of any nature whatsoever.

8. I have read this waiver above and hereby give my consent and approval to my Teen's participation.

  *This question is required.
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